IMPACT Foundation 151 Western Road Haywards Heath RH16 3LH Tel: 01444 457080 Email: [email protected] www.impact.org.uk Final report for the Eagle Foundation – September 2016 Maternity equipment for Phnom Srok Referral Hospital, Banteay Meanchey Province, Cambodia File form: 00365 Phnom Srok hospital was one of the former Khmer Rouge facilities (1972-1979) and much of the equipment and infrastructure dates to this period. Thanks to the support of the Eagle Foundation, IMPACT Cambodia has equipped the hospital with an ultra-sound machine and haematology analyser. These are vital instruments for monitoring pregnancies and identifying life-threatening complications in mothers and babies. Since the new instruments have been in place, the hospital has seen a marked increase in women attending antenatal screening appointments. The hospital staff are enormously grateful for the equipment, which has improved the level of care they can provide to the poorest patients they serve. Project update Ultrasound machine We are pleased to report that the hospital’s new ultrasound machine was delivered and installed towards the end of June. In the three months since it has been operational, 150 women have had their pregnancies scanned. It has also been used as a diagnostic tool for 36 patients with non-pregnancy related conditions, such as cysts and intestinal problems. The hospital’s two secondary midwives have undergone training in ultrasonography under the auspices of the Dr Sovannarith showing patients images of their pregnancies National Maternal and Child Health Centre. Furthermore, the hospital has assigned Dr Sovannarith as the lead sonographer and he has since completed refresher training, at Kantha Bopha Hospital in Siem Reap, covering both obstetric/gynaecological and abdominal uses of the technology. ‘I am very happy that Phnom Srok Hospital can provide ultrasound service for the people in this area. When I first arrived here, there were only two doctors including me. I have seen that there was not enough medical equipment for providing health care service, especially most of pregnant women have never received ultrasound service. This ultrasound test is important for health, and as well because they do not need to spend extra expenses on transportation elsewhere. I promise that I will try to study hard and do my best for providing a better health care service and more effectively for the people in this area.’ - Dr Sovannarith Word has spread about the ultrasound machine and IMPACT Cambodia report a surge in women requesting pregnancy monitoring over the past month. In order to help meet the demand, another doctor from the hospital will be undertaking ultrasound training in Phnom Penh starting on 5th November. The hospital’s head midwife, Nov Vichek, shared her response to the new ultrasound machine; ‘Previously, pregnant women in my area have never used ultrasound service. (In these past few years, only mothers who can afford ultrasound service fee can go to use this service at the private clinic.) But now, I am sure that all the pregnant women in my area will use this ultrasound service up to four times during their pregnancy. The ultrasound test can show us about the vital risk sign of both the mother and baby. So we can tell pregnant women about how to have self-care during pregnancy more properly, or we can advise them to have delivery at the provincial hospital. Before having these two new machines, we transferred an average of 70 in 100 pregnant women to the provincial hospital. Now it is only required in 30 to 40 per 100 pregnant women. Providing ultrasound service in this hospital does not only help my work become easier - pregnant women can know about their baby’s growth and health. I can see their smile every time after they received ultrasound service.’ - Nov Vichek, head midwife Haematology analyser As described in our May 2016 interim report, your grant has equipped the hospital with a computerised haematology analyser for use in general medicine and within the maternity unit. Samples of blood can now be quickly analysed for signs of disease and it is used to check expectant mothers for conditions such as anaemia, which can impact a woman’s birthing plan. The new machine can analyse up to 30 blood samples per hour, and produces a far more accurate reading than the previous microscope, whose results had to be interpreted by a laboratory technician. ‘The haematology analyser is very important for my work. The new computerised haematology machine was installed towards the end of April 2016 All pregnant women need to have blood test before we can plan their delivery. After having blood test through this machine, in case the result shows there is problem, I can manage can manage my work on how to save her on time, or make arrangements to transfer her to the provincial hospital’ - Head Midwife, Nov Vicheka Case studies In August, Sonita Pong (IMPACT Cambodia Field Officer), spent a day observing the use of the new ultrasound machine and she recorded the following case studies: Case study 1 - ‘Sok Sarem, 31 years old, lives in Srah Chik Kharng Lech Village, Srah Chik Commune, Phnom Srok District comes to have prenatal checkup at the hospital for her second time. Sarem was very happy when the ultrasound test showed that her baby is healthy. She could see that her baby has now healthily developing. The baby is now weighing 750g (before was 350g)’. Case study 2 - ‘Ses Srey Vorn, lives in Phom Srok district, came to receive ultrasound test for the very first time in life at Phnom Srok Referral Hospital. She is 24 years old and in her five months of pregnancy. Srey Vorn had never heard about ultrasound test and she would not even know what the doctor would do to her with that machine. This time, because most of her neighbours encouraged her to come (her neighbours came to receive ultrasound test before her), she agreed. After Ses Srey Vorn is examined by receiving the test, she was told that her baby is in very Dr Sovannarith good condition, and will grow well. Srey Vorn was in tears of happiness, knowing that her baby is healthy and finally knew it what is ultrasound test. She told me, “This is my first child and my first time knowing what is ultrasound test too. This is such a relief. There are many pregnant women in our village that have never had received ultrasound test, and I will tell them when I get back home.” Case study 4 - Thik Vatanak, 35 years old, lives in Kamping Pouy village. Vatanak did not receive ultrasound test for her first child. This time, for her second child, she came to receive ultrasound test at the hospital. The result showed that the foetus is a boy and weighs 2.4 kg. From the test, Vatanak was told that her baby has nuchal cord [when the umbilical cord becomes wrapped around the baby’s neck]. Vatanak told me that, “Without the ultrasound test, I would not know what my baby is facing. Because of this test, I will not have the Thik Vatanak delivery at home and I will come to Phnom Srok Hospital for delivery. This is another experience for me because I did not receive the test for my first child and I will make sure to not miss any tests if I have my third child later.” Kly Pok Case study 5 - Kly Pok, 21 years old, lives in Kandal Khang Keut village. Pok too, like most of the pregnant women in her commune, has never received ultrasound test before. It is her first child and she is now in her six months pregnancy period. She was told that her baby girl is healthy. She was happy and said, “I thought I can only see my baby until delivery date. I think many pregnant women in my village should come to receive the service too, because they are like me, know nothing about this service.” Case study 6 - Mut Mao is 34 years old. She lives in Moat Srah village. Mao has gone through two times of miscarriage within three years. Back in 2010, she was not able to keep her first child because of her living condition. She had to work from dawn then come back in the evening. She could not find some times to rest nor eat proper meals. The second pregnancy, again she felt serious pain in her abdomen and went straight to a hospital in. Doctor told that she already lost her baby. She was very shock and regret at the same time. They asked her to take care of herself more and gave her some advices about ultrasound test. For the third time of her pregnancy, she became more cautious with her health condition and regularly went for ultrasound test as but this was costly and took time as she had to travel to the Provincial Hospital in Banteay Mean Chey Mut Mao Province. The third baby was safe. At present, she is in her fourth pregnancy period. It is more convenient for her as she feels relieved as she know there is ultrasound test in Phnom Srok Hospital. Thank you The acquisition of these two machines has made a huge difference to the hospital on many levels. Before their purchase, women would have to travel 70km for blood or ultrasound tests at the nearest provincial hospital. In July the number of patients at Phnom Shrok was up from an average of 1,000 to 2,357 people and two new doctors have been approved by the health ministry to start work at the hospital.